Animal Assisted Therapy in the Geriatric Population
I chose this topic to highlight an option to supplement standard physical therapy treatment in the geriatric population. We have learned that often the focus of treatment in this population is so focused on physical aspects that the emotional and mental aspects can be downplayed. I wanted to explore how the use of animal assisted therapy could impact the function and quality of life of geriatric patients.
Objectives:
The objectives of this page are to:
Learn about the effects of nursing homes and assisted living on the geriatric population
Understand the definition and premise behind animal assisted therapy
Learn about the techniques used in animal assisted therapy
Learn about the evidence for animal assisted therapy in older adults
Summarize the information and recommendations from the research presented
Information About the Geriatric Population in Facilities
According to a study by Engelman, when elderly people are transferred to nursing homes or long term care facilities, they often become passive, agitated, withdrawn, depressed, and inactive because of the lack of regular visitors or the loss of loved ones.6 In addition, a study by Friedmann et al states that dementia prevalence in assisted living ranges from approximately 42% to 67%.Assisted living residents with dementia are more likely to experience greater functional disability and neuropsychiatric symptoms than residents without dementia.Functional impairment and increased emotional and behavioral symptoms lead to relocation of assisted living residents to more comprehensive and expensive care situations.2
About Animal Assisted Therapy
While we are going into the wonderful field of physical therapy, we must also remember that we need to be sure that every aspect of the patient is cared for to allow for the highest quality of life. Buettner et al defines animal assisted therapy (AAT) as “a goal-directed intervention in which an animal is an integral part of the treatment process.”5 AAT involves interactions between clients and trained animals, directed and/or delivered and documented by a health or human service professional with a specific clinical goal. Supporters of AAT say that animals can be helpful in motivating the patients to be active mentally and physically, keeping their minds sharp and bodies healthy.Therapists or visitors who bring animals into their sessions at the nursing home are often viewed as less threatening, which increases the relationship between the therapist/visitor and patient.6
Techniques Used in Animal Assisted Therapy
There are multitudes of different ways to implement AAT in a patient’s plan of care. Animal assisted therapy programs can motivate physical movement through planned tasks, such as petting, walking, and grooming as well as encourage expressions of emotions and cognitive stimulation through discussions and reminiscing. Many of the troubling secondary problems common in people with dementia, such as falls, decreased physical functioning, deconditioning after hospitalization, disturbing behaviors, apathy, depression, and loneliness are positively affected by AAT interventions. AAT is particularly useful in post-acute rehabilitation units and restorative nursing sessions, to focus attention, motivate increased practice time, and encourage communication skills for those with memory loss.5
Furthermore, AAT offers important social interactions that provide opportunities for mutual interactions promote dignity and self-esteem. AAT provides older adults with opportunities to have close physical contact with warm bodies, feel heartbeats, caress soft skin and coats, notice breathing, and give hugs. These experiences may seem silly to us, but for an older person in long-term care, they could be extremely rare and valuable. Animals are able to provide a sense of wonder, meaning, and diversion, and offer something to look forward to.5
Evidence for Use of Animal Assisted Therapy in the Geriatric Population
There have been many studies on the effectiveness and outcomes of AAT in different settings. A study by Marcus et al demonstrated that therapy dog visits in an outpatient setting could provide significant reduction in pain and emotional distress for chronic pain patients.The dog visits were also found to significantly improve emotional distress and feelings of well being in family and friends accompanying patients to appointments and clinic staff.1 In assisted living situations, Friedmann et al says that physical activity depressive symptoms improved more with AAT and the program helps preserve/enhance function of residents with cognitive impairment.2 A study conducted in an acute care hospital by Pullen et al showed that the use of AAT for 30 minute sessions improved mood by 58% and improved function by 54%.3 A systematic review of RCTs looking at the effectiveness of AAT found that in a study environment limited to the people who like animals, AAT may be an effective treatment for mental and behavioral disorders such as depression, schizophrenia, and alcohol/drug addictions. Additionally, they showed the direct effects of AAT to be general improvement of mental health, elimination of the sense of isolation, and an improvement in quality of life.4
Summary
In conclusion, physical therapists must understand the holistic treatment of the geriatric patient is most beneficial to their quality of life and well-being. We as therapists must understand the options out there that can be used to supplement our treatments and allow for the betterment of the patient not only physically, but mentally as well. Animal assisted therapy has been shown to improve patient’s outcomes in quality of life and functionality, as well as giving them close physical contact to bolster their self-esteem. We must know and properly advocate for the use of AAT in geriatric patients suffering from diagnoses such as depression or other mental illnesses that we believe could benefit from AAT.
References
1. Marcus, D. A., Bernstein, C. D., Constantin, J. M., Kunkel, F. A., Breuer, P., & Hanlon, R. B. (2012). Animal-assisted therapy at an outpatient pain management clinic.Pain Medicine (Malden, Mass.), 13(1), 45-57. doi:http://dx.doi.org/10.1111/j.1526-4637.2011.01294.x
2. Friedmann, E., Galik, E., Thomas, S. A., Hall, P. S., Chung, S. Y., & McCune, S. (2015). Evaluation of a pet-assisted living intervention for improving functional status in assisted living residents with mild to moderate cognitive impairment: A pilot study. American Journal of Alzheimer's Disease and Other Dementias, 30(3), 276-289. doi:http://dx.doi.org/10.1177/153331751454547
3. Püllen, R., Coy, M., Hunger, B., Koetter, G., Spate, M., & Richter, A. (2013). Animal-assisted therapy for demented patients in acute care hospitals]. Zeitschrift Fur Gerontologie Und Geriatrie, 46(3), 233-236. doi:http://dx.doi.org/10.1007/s00391-013-0478-8
4. Kamioka, H., Okada, S., Tsutani, K., Park, H., Okuizumi, H., Handa, S., Mutoh, Y. (2014). Effectiveness of animal-assisted therapy: A systematic review of randomized controlled trials. Complementary Therapies in Medicine, 22(2), 371-90. doi:http://dx.doi.org/10.1016/j.ctim.2013.12.016
5. Buettner, Linda L, PhD,L.R.T., C.T.R.S., Fitzsimmons, Suzanne,M.S., A.R.N.P., & Barba, Beth, PhD, RN,F.A.G.H.E., F.A.A.N. (2011). Animal-assisted therapy for clients with dementia. Journal of Gerontological Nursing, 37(5), 10-14. doi:http://dx.doi.org/10.3928/00989134-20110329-05
I chose this topic to highlight an option to supplement standard physical therapy treatment in the geriatric population. We have learned that often the focus of treatment in this population is so focused on physical aspects that the emotional and mental aspects can be downplayed. I wanted to explore how the use of animal assisted therapy could impact the function and quality of life of geriatric patients.
Objectives:
The objectives of this page are to:
Information About the Geriatric Population in Facilities
According to a study by Engelman, when elderly people are transferred to nursing homes or long term care facilities, they often become passive, agitated, withdrawn, depressed, and inactive because of the lack of regular visitors or the loss of loved ones.6 In addition, a study by Friedmann et al states that dementia prevalence in assisted living ranges from approximately 42% to 67%.Assisted living residents with dementia are more likely to experience greater functional disability and neuropsychiatric symptoms than residents without dementia.Functional impairment and increased emotional and behavioral symptoms lead to relocation of assisted living residents to more comprehensive and expensive care situations.2
About Animal Assisted Therapy
While we are going into the wonderful field of physical therapy, we must also remember that we need to be sure that every aspect of the patient is cared for to allow for the highest quality of life. Buettner et al defines animal assisted therapy (AAT) as “a goal-directed intervention in which an animal is an integral part of the treatment process.”5 AAT involves interactions between clients and trained animals, directed and/or delivered and documented by a health or human service professional with a specific clinical goal. Supporters of AAT say that animals can be helpful in motivating the patients to be active mentally and physically, keeping their minds sharp and bodies healthy.Therapists or visitors who bring animals into their sessions at the nursing home are often viewed as less threatening, which increases the relationship between the therapist/visitor and patient.6
Techniques Used in Animal Assisted Therapy
There are multitudes of different ways to implement AAT in a patient’s plan of care. Animal assisted therapy programs can motivate physical movement through planned tasks, such as petting, walking, and grooming as well as encourage expressions of emotions and cognitive stimulation through discussions and reminiscing. Many of the troubling secondary problems common in people with dementia, such as falls, decreased physical functioning, deconditioning after hospitalization, disturbing behaviors, apathy, depression, and loneliness are positively affected by AAT interventions. AAT is particularly useful in post-acute rehabilitation units and restorative nursing sessions, to focus attention, motivate increased practice time, and encourage communication skills for those with memory loss.5
Furthermore, AAT offers important social interactions that provide opportunities for mutual interactions promote dignity and self-esteem. AAT provides older adults with opportunities to have close physical contact with warm bodies, feel heartbeats, caress soft skin and coats, notice breathing, and give hugs. These experiences may seem silly to us, but for an older person in long-term care, they could be extremely rare and valuable. Animals are able to provide a sense of wonder, meaning, and diversion, and offer something to look forward to.5
Evidence for Use of Animal Assisted Therapy in the Geriatric Population
There have been many studies on the effectiveness and outcomes of AAT in different settings. A study by Marcus et al demonstrated that therapy dog visits in an outpatient setting could provide significant reduction in pain and emotional distress for chronic pain patients.The dog visits were also found to significantly improve emotional distress and feelings of well being in family and friends accompanying patients to appointments and clinic staff.1 In assisted living situations, Friedmann et al says that physical activity depressive symptoms improved more with AAT and the program helps preserve/enhance function of residents with cognitive impairment.2 A study conducted in an acute care hospital by Pullen et al showed that the use of AAT for 30 minute sessions improved mood by 58% and improved function by 54%.3 A systematic review of RCTs looking at the effectiveness of AAT found that in a study environment limited to the people who like animals, AAT may be an effective treatment for mental and behavioral disorders such as depression, schizophrenia, and alcohol/drug addictions. Additionally, they showed the direct effects of AAT to be general improvement of mental health, elimination of the sense of isolation, and an improvement in quality of life.4
Summary
In conclusion, physical therapists must understand the holistic treatment of the geriatric patient is most beneficial to their quality of life and well-being. We as therapists must understand the options out there that can be used to supplement our treatments and allow for the betterment of the patient not only physically, but mentally as well. Animal assisted therapy has been shown to improve patient’s outcomes in quality of life and functionality, as well as giving them close physical contact to bolster their self-esteem. We must know and properly advocate for the use of AAT in geriatric patients suffering from diagnoses such as depression or other mental illnesses that we believe could benefit from AAT.
References
1. Marcus, D. A., Bernstein, C. D., Constantin, J. M., Kunkel, F. A., Breuer, P., & Hanlon, R. B. (2012). Animal-assisted therapy at an outpatient pain management clinic.Pain Medicine (Malden, Mass.), 13(1), 45-57. doi:http://dx.doi.org/10.1111/j.1526-4637.2011.01294.x
2. Friedmann, E., Galik, E., Thomas, S. A., Hall, P. S., Chung, S. Y., & McCune, S. (2015). Evaluation of a pet-assisted living intervention for improving functional status in assisted living residents with mild to moderate cognitive impairment: A pilot study. American Journal of Alzheimer's Disease and Other Dementias, 30(3), 276-289. doi:http://dx.doi.org/10.1177/153331751454547
3. Püllen, R., Coy, M., Hunger, B., Koetter, G., Spate, M., & Richter, A. (2013). Animal-assisted therapy for demented patients in acute care hospitals]. Zeitschrift Fur Gerontologie Und Geriatrie, 46(3), 233-236. doi:http://dx.doi.org/10.1007/s00391-013-0478-8
4. Kamioka, H., Okada, S., Tsutani, K., Park, H., Okuizumi, H., Handa, S., Mutoh, Y. (2014). Effectiveness of animal-assisted therapy: A systematic review of randomized controlled trials. Complementary Therapies in Medicine, 22(2), 371-90. doi:http://dx.doi.org/10.1016/j.ctim.2013.12.016
5. Buettner, Linda L, PhD,L.R.T., C.T.R.S., Fitzsimmons, Suzanne,M.S., A.R.N.P., & Barba, Beth, PhD, RN,F.A.G.H.E., F.A.A.N. (2011). Animal-assisted therapy for clients with dementia. Journal of Gerontological Nursing, 37(5), 10-14. doi:http://dx.doi.org/10.3928/00989134-20110329-05
6. Engelman, S. R. (2013). Palliative care and use of animal-assisted therapy. Omega, 67(1-2), 63-67. Retrieved from http://152.12.30.4:2048/login?url=http://search.proquest.com/docview/1428516397?accountid=15070